Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome

Abstract

Some of the interventions can decrease prostatitis symptoms in an appreciable number without a greater incidence of adverse events. The QoE was mostly low. Future clinical trials should include a full report of their methods including adequate masking, consistent assessment of all patient-important outcomes including potential treatment-related adverse events and appropriate sample sizes.

Acute and chronic prostatitis

“…Cognitive behavioural therapy (CBT) is useful for psychosocial effects and phosphodiesterase-5 inhibitors (for example, sildenafil) are recommended for sexual dysfunction. Finally, a recent Cochrane review (Franco et al, 2018) showed that acupuncture has been shown to reduce symptoms compared with standard medical therapy.…”

Extracorporeal Shockwave Therapy (ESWT) Alleviates Pain, Enhances Erectile Function and Improves Quality of Life in Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome

“…Over the last six decades, CP/CPPS, attributed to infection, inflammation, impaired urothelial integrity and function, endocrine imbalance, autoimmunity, voiding dysfunction, or neuropsychological factors [7,8], has remained a 'diagnosis of exclusion' with currently unclear or inexact underlying cause, thus stimulating interest and concerted research effort to demystify its etiology and unravel probable underlying molecular mechanisms. Recently, Trichomonas Vaginalis infection has been suggested as a probable pathoetiologic factor in CP/CPPS because of its complicity in chronic persistent prostatic infection and prostate epithelial cell inflammation [9].…”

“…The magnitude of effect and the disproportional mean decrease in the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and response rates in treatment groups in comparison to placebo groups suggest the superiority of directed multi-modal therapy over monotherapy, and advocate consideration of these agents for optimal management of patients with CP/CPPS [17]. Alternatively, phytotherapies, including quercetin, Cernilton, Eviprostat/pollen extract, and pentosane polysulfate [17,18], as well as non-pharmacological therapies such as acupuncture and extracorporeal shockwave therapy (ESWT), have also shown some efficacy in the treatment of CP/CPPS [8].…”

“…As already mentioned, non-pharmacological therapies are also touted as effective against CP/CPPS [8,22]. ESWT is one such non-pharmacological treatment modality [22].…”

Comparing two different low‐intensity shockwave therapy frequency protocols for nonbacterial chronic prostatitis/chronic pelvic pain syndrome: A two‐arm, parallel‐group randomized controlled trial

“…6 In particular, in a recent Cochrane systematic review exploring the efficacy and safety of the available nonpharmacological CP/CPPS treatments, low-intensity shockwave therapy (LiST) emerged as a novel, promising treatment modality that improves pain and other CP/CPPS symptoms without presenting serious adverse events. 7 Despite these encouraging findings, to date, LiST has failed to derive sufficient guideline recommendations supporting its application as a part of the CP/CPPS treatment algorithm. 8,9 The latter was attributed to the high heterogeneity in terms of LiST duration, frequency and number of sessions, as well as to the different shockwave generators and energy setting applied across the available randomized controlled trials (RCTs).…”